| Dr Ellsworth Raymond Grant, MD | |
|
1245 Wilshire Blvd, Suite 801, Los Angeles, CA 90017-4810 | |
| (213) 481-3948 | |
| (213) 481-1697 |
| Full Name | Dr Ellsworth Raymond Grant |
|---|---|
| Gender | Male |
| Speciality | Hematology/oncology |
| Experience | 35 Years |
| Location | 1245 Wilshire Blvd, Los Angeles, California |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043233760 | NPI | - | NPPES |
| 954893061 | Other | CA | TAX ID NO. |
| 00G730841 | Medicaid | CA | |
| 00G730842 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RH0003X | Internal Medicine - Hematology & Oncology | G73084 (California) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Oncology Institute Ca, A Professional Corporation | 5698872398 | 90 |
| Entity Name | The Oncology Institute Ca, A Professional Corporation |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275651515 PECOS PAC ID: 5698872398 Enrollment ID: O20070514000607 |
| Entity Name | Ellsworth Grant, M.d., Medical Corp |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538247424 PECOS PAC ID: 9335200476 Enrollment ID: O20081208000082 |
| Entity Name | County Of Los Angeles |
|---|---|
| Entity Type | Part B Supplier - Ambulatory Surgical Center |
| Entity Identifiers | NPI Number: 1780877613 PECOS PAC ID: 1850296534 Enrollment ID: O20090713000358 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ellsworth Raymond Grant, MD 1245 Wilshire Blvd, Suite 801, Los Angeles, CA 90017-4810 Ph: (213) 481-3948 | Dr Ellsworth Raymond Grant, MD 1245 Wilshire Blvd, Suite 801, Los Angeles, CA 90017-4810 Ph: (213) 481-3948 |
Dr. Linda Fong, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 6041 Cadillac Ave, Los Angeles, CA 90034 Phone: 323-857-3290 | |
Dr. Robert Peter Gale, Hematology & Oncology Medicare: Medicare Enrolled Practice Location: 11693 San Vicente Blvd, Suite 335, Los Angeles, CA 90049 Phone: 310-442-9010 | |
Dr. Tarek Alasil, MD Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 8616 La Tijera Blvd Ste 404, Los Angeles, CA 90045 Phone: 310-673-2020 Fax: 310-469-5290 | |
David Michael Tellalian, MD Hematology & Oncology Medicare: Medicare Enrolled Practice Location: 8635 W 3rd St Ste 465w, Los Angeles, CA 90048 Phone: 310-358-2300 Fax: 310-358-2308 | |
Dr. Jan B King, M.D., M.P.H. Hematology & Oncology Medicare: Not Enrolled in Medicare Practice Location: 11833 Wilmington Ave Fl 2, Los Angeles, CA 90059 Phone: 323-568-8701 | |
Dr. Caroline Hwang, M.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 1520 San Pablo St, Suite 1000, Los Angeles, CA 90033 Phone: 323-442-5100 | |
Dr. Jennifer A Fulcher, M.D., PH.D. Hematology & Oncology Medicare: Accepting Medicare Assignments Practice Location: 10833 Le Conte Ave, Chs 37-121, Los Angeles, CA 90095 Phone: 310-825-7225 |